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Skin Care and Diseases

Pebble-like lumps under daughter`s skin

10/03/2006

Question:

Thanks for reading my question. My daughter has two areas on her body (right shin, left foot) that have small, hard lumps under her skin. She was x-rayed and a CT scan was performed to rule out the possibility of it being on the bone. The one on her right shin got half-dollar size but was not red or inflammed at all, and she said it hurt "sometimes". It eventually broke up into three smaller lumps but has not gone away. A dermatologist took a biopsy of the lump on her left foot and said it was Granuloma Annulare. I have trouble agreeing with him! The lumps on my daughter do not resemble the case photos I have seen in the least. My daughter has had none of the typical symptoms or appearance of GA. Can you offer any suggestions to point me in the right direction (as to what this could be)? Thank you for your time.

Answer:

I read the history that you provided with interest.  Recognize that granuloma annulare may produce large lesions that have in the past been mistaken for rheumatoid nodules.  The histology, however, should alleviate your concerns.  If there is a question, then I would suggest that you have a second opinion from another dermatologist, and may also ask for a biopsy and/or have the original biopsy read by another dermatopathologist.  In this way, errors can be minimized.  Once the diagnosis is established then your board certified dermatologist can help you treat the disorder.

 

 

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Response by:

Charles L Heaton, MD
Professor
College of Medicine
University of Cincinnati